Wednesday, April 10, 2013

Stigma has ‘a long way to go’

Former First Lady reflects 40-plus years of fighting stigma

Some months ago, Lori Ashcraft, Ph.D., an editorial board member and longtime contributor of the popular “Tools for Transformation” column, suggested that Behavioral Healthcare ought to interview Rosalynn Carter, wife of former President Jimmy Carter and one of the world’s most prominent mental health advocates. The exclusive interview that follows, along with other stories about the 28th Rosalynn Carter Symposium on Mental Health in Atlanta last November, are proof of what a good idea and a little determination can accomplish.

In 1966, the idea of advocating for people with mental illnesses was even less popular than it is today, cloaked in shame, stigma, and discrimination. Mrs. Carter took it on anyway and for the past four decades has addressed issues related to consequences of mental illness that cry out for reinvention and transformation. She seems to come from a place that overrides fear and shame and goes right to compassion. And it’s the compassion that has fueled her commitment to a segment of our population that had been dismissed as having nothing meaningful to contribute to our society and needing nothing more than ‘to be taken care of.’

Rosalynn Carter has been one of the longest and strongest voices for transforming the views held about mental illness and the systems that supposedly treat it. She was an early supporter of the recovery movement and believes that it has set the foundation for a new set of beliefs regarding the potential of those who have been diagnosed. She is a strong supporter of the peer movement, saying that, ‘next to recovery, it is the best thing that has happened yet.’

In chairing her 28th Mental Health Symposium, Mrs. Carter now focuses her passion on community inclusion, an evolution of the needs expressed by her fellow Georgians so many years ago. She wants people who are on their recovery journey to have access to community resources so they will be able to contribute in a meaningful way to their communities. The timing could not be better: the Symposium’s participants and findings will be harnessed to develop policy recommendations to support this end.

There is a sense of urgency in her voice as she describes her hopes for the future.

BH: What was it that got you involved in the cause of mental health?

Mrs. Carter: I became interested while campaigning with my husband, when he ran for governor in 1966. He got into that race late, after our leading Democratic candidate had a heart attack, leaving Lester Maddox, a very popular segregationist, as the only candidate. When no one else would take him on—this being the midst of the civil rights days—Jimmy decided that he would run. I had never campaigned before, and it was already eight to 10 weeks before the election, so Jimmy (then a Georgia state senator) went one way and I went the other. Every day, somebody would ask me, ‘What will you do for my mentally ill loved one at Central State Hospital?’ There had just been a big exposé about the hospital in the news—it was happening all over the country. The Community Mental Health Act had been passed [in 1963], but the state was moving people out of the hospital before the any services were there for them. I became very concerned about the issue, and even though Jimmy lost that time, I kept learning more about it.

When Jimmy became Governor in 1972, he appointed a commission to improve services to mentally and emotionally handicapped people. That’s where my real education began . . .

BH: Where are we today, and where do we need to go in terms of mental health treatment in the United States?

Mrs Carter: We have a long way to go. But there are movements in the mental health field that are very important right now. One involves community services. Another is community inclusion. Another is how treatment is moving toward recovery. And, there’s the idea of integrating services, mental health and primary care, getting rid of the separation between physical and mental health care. All of those are good.

But, the stigma and discrimination against mental health issues has always been so bad. Stigma curtails funding for services, it hurts programs in the community, and stands in the way of getting policymakers—the people who can make a difference—interested in the issue.